The director of Mass General’s Research Recovery Institute offers practical advice about how to help a friend or family member seek addiction treatment.

The nation faces an epidemic of drug and alcohol misuse. Every day, we hear news about related overdoses and accidental deaths as well as renewed city, state and federal attempts to stem the tide. So what should a friend or family member do if they think a loved one is in need of addiction treatment?

This is not a moral failing or character weakness.

There are a variety of highly effective professional treatments for alcohol and other drug problems. There are also freely available mutual-help organizations that offer help and hope for those suffering from addiction; these include Alcoholics Anonymous (AA), Narcotics Anonymous (NA) and SMART Recovery.

Unfortunately, stigma prevents many people from admitting that a problem exists, whether it be in themselves or a family member, and to consequently seek the help they need. Science has taught us, however, that just like other serious medical illnesses, addiction is caused by the interaction of genetics and environment; about half the risk for addiction is conferred by genetics. Also, exposure to drugs and alcohol can radically impair brain systems, making it extremely difficult for people to regulate and control their impulses to use substances. This is not a moral failing or character weakness.

Getting Addiction Treatment Earlier

Even so, it is often difficult to approach your friend or loved one about their suspected alcohol or drug problem. You don’t want to lose their trust or make them upset with you when you are there to support them. But encouraging them to seek additional help and support is likely the best option and, as with other illnesses, getting treatment earlier is associated with better health and earlier recovery.

Try to begin the conversation and express concern at a moment when they are most likely to hear it.

Try to begin the conversation and express concern at a moment when they are most likely to hear it. Ideally, they should be sober. A time when they are upset or remorseful about something that happened while they were intoxicated can be an ideal opening.

Tell them how you have seen drugs or alcohol affect their mood and behavior. Give specific examples. A spouse might mention feeling afraid or vulnerable. Be positive. Let them know that you and others care about them and can help. Offer to assist them in getting help. Suggest that your loved one at least have a phone conversation with a supportive and knowledgeable clinician or someone at a local addiction treatment center. Have some phone numbers handy.

Signs of a Problem

How can you tell whether it might be time to start that conversation?

Below are a few psychological and physical symptoms that might help you decide along with some resources that can help you and your loved one begin the road to recovery. You’ll also find additional information on the Research Recovery Institute’s website.

Psychological and Behavioral Signs and Symptoms

  • Alcohol and drugs begin to take an increasingly important role in their life
  • The person spends more and more time drinking or using drugs
  • The person begins to drink or use higher amounts
  • The person is more often seen as under the influence of alcohol or other drugs
  • The person sees alcohol or drugs as a solution rather than a problem
  • They become preoccupied constantly with obtaining drugs or alcohol
  • They often feel anxious, irritable, depressed or moody
  • They may skip work or school because of hangover effects from alcohol/drugs
  • They have difficulty fulfilling responsibilities

Physical Signs and Symptoms

  • Sleep becomes disrupted and irregular
  • They feel and appear fatigued and tired
  • They may have accidents and suffer physical health problems
  • They may noticeably gain or lose weight
  • They experience physical withdrawal symptoms when not drinking/using drugs (e.g., sweats, tremors, grey shiny skin)

Helpful Resources

  • The website of the federal government’s Substance Abuse and Mental Health Services Administration (SAMHSA) offers information and resources including a tool that allows you to find treatment services by zip code. You can also call SAMHSA’s National Helpline at 1-800-662-HELP (4357)
  • The West End Clinic is a Mass General outpatient facility for those with alcohol and drug addictions, co-occurring mental health disorders and other types of addictive behaviors. The clinic offers outpatient therapies, medication treatment and other resources. For more information or to schedule an appointment, call 617-724-7792.
  • Mass General’s Addiction Recovery Management Service specializes in supporting teenagers and young adults between the ages of 14 and 26, and their parents, as they deal with their substance use and related problems. For more information or to schedule an appointment, call 617-643-4699.

To learn more about how you can support addiction medicine at Mass General, please contact us.


John F. Kelly, PhD, is the founder and director of the Recovery Research Institute, the program director of the Addiction Recovery Management Service (ARMS), and the associate director of the Center for Addiction Medicine, all at Massachusetts General Hospital. Dr. Kelly is also the Elizabeth R. Spallin Associate Professor of Psychiatry at Harvard Medical School.